Most patients don't understand post-discharge care plans, study finds

Most patients don't understand their post-discharge care plans because they're written for those with advanced reading skills, a new study finds. Discharge notes should be understandable for those reading at a sixth-grade level, the researchers said.

The study, published in the American Journal of Surgery, found that 65 percent of the nearly 500 trauma patients studied had functional reading skills at grade levels below that required to understand the discharge notes. Only 24 percent had the reading skills to fully comprehend the summary.

Additionally, 65 percent of those readmitted within 30 days were unable to read at the level necessary to understand their discharge notes.

The study noted that nearly half the U.S. population is only marginally literate, meaning they can read and comprehend at an elementary- or middle-school level, Reuters reported. But another reason the notes may be difficult to understand is they're written for doctors as well as patients and their families, senior study author Martin Zielinski, M.D., a trauma surgeon at the Mayo Clinic, told the news outlet.

"Even if patients believe they understand what occurred during their hospitalization and the instructions they are to follow upon dismissal, they can become confused after they leave the hospital," Zielinski said.

Providers can test their patients' comprehension by asking them to review instructions and summarize them in their own words, as FierceHealthcare previously reported. Other proactive approaches include being careful with wording--such as asking patients what their questions are rather than whether they have any questions--and using charts and graphs when possible to explain concepts that may be difficult to understand.

The consequences of limited health literacy can be severe, and can lead to medication errors, lack of follow-through on tests and even higher mortality rates for patients with acute heart failure.